What is Metrorrhagia? it also known as the dysfunctional uterine bleeding is a problem that women suffer from. Metrorrhagia is common, especially to the first few years of menstrual onset (pubertal metrorrhagia). It is also observed with patients who are near to their menopausal phase. Basically, this condition is characterized by bleeding episodes (mainly spotting but can lead to severe bleeding) outside the menstrual phase.
Accordingly, the bleeding episode is described as irregular in amount and in pattern. In light of the normal menstrual cycle of women, the designated menstrual phase (commonly known as the menses) should be an average of 4 days and should occur the next month later. To simplify, metrorrhagia is an in between vaginal spotting in monthly menses, a considered possible health threat and should not be taken lightly. This should prompt the affected to seek medical advice for a number of underlying conditions may be causing such abnormality. But take note, one should not panic and consider it caused by a dreaded disease.
Metrorrhagia is considered a symptom of a possible health problem but shouldn’t be handled as a serious health problem right away. One should not panic when spotting is observed. It is highly advised to seek a gynecologist’s advice for the confirmation of an underlying condition.
What to do when abnormal vaginal spotting and bleeding (metrorrhagia) is observed in between menses?
There are cases where women have menstrual spotting during the time of ovulation, which is basically considered normal. In order to be sure that one is having vaginal spotting, one can check herself before seeking medical advice. Self-examination should be done and to make sure that the source of blood is from the vagina. In order to attain that, one can use a tampon to check the source and confirm it is from the vagina. When it is established, one should seek medical advice to attain proper diagnosis and intervention of the probable cause.
What To Expect During The Medical Examination?
As one seeks a medical advice, the doctor shall obtain your medical history. It is important when asked by the doctor that the following are provided:
- History of recent abortion (if any)
- If bleeding was caused postcoitus
- Use of contraception such as IUDs or the pill (oral contraceptives)
- Information about menstrual cycle
- Past medical conditions e.g. history of bleeding disorders and other chronic conditions (HIV)
- Diet history
- History of sexual activity
The doctor shall perform a pelvic/vaginal examination. This can help determine presence of any uterine problem. It is also necessary to undergo imaging tests such as transvaginal sonography. A magnetic resonance imaging is also done in order to find tumors that are not quite visible with sonography. A Pap smear is also necessary to identify presence of sexually transmitted infections. There are also cases where biopsy is essential.
Causes of Metrorrhagia
- Endometrial hyperplasia. This condition is said to be a result of abnormal levels of estrogen and decreased levels of progesterone. This abnormality in hormonal levels would then prompt excessive endometrial cells.
- Uterine cancer. This is considered a common cause of the metrorrhagia. Increasing age is related to uterine cancer, making postmenopausal women as victims of the uterine cancer. Tumors such as those found in ovarian cysts can result to abnormal off-menstrual bleeding.
- Ruptured polyps. There are cases where a woman is unaware that she has cervical polyps. Somehow, after sexual contact, it will be identified. Postcoital bleeding should not be taken lightly, as this may indicate for presence of polyps in the cervix or endometrium.
- Cervical dysplasia. This condition is a pre-cancer stage that involves vaginal spotting as a symptom. This may be indicative that cancer development is in progress.
- Cervicitis. This is known as infection of the cervix. Bleeding during the infection would indicate prompt attention as this may progress to a chronic problem.
- Abortion or miscarriage. This is a common cause of vaginal bleeding. There are cases where after abortion, fetal parts are left that can cause for vaginal infection and bleeding.
- Infection. Sexually transmitted infection/s is a probable cause of metrorrhagia. Syphilis is known to cause vaginal bleeding. Those who have Lyme disease are prone to metrorrhagia as they become susceptible to infections.
- Hormonal imbalance. There are underlying conditions such as hyperthyroidism/hypothyroidism that cause hormonal imbalance.
- Coagulation problems. Women who have an underlying coagulation (blood clotting) problem such as those prone to bleeding are highly susceptible to metrorrhagia.
- Use of contraception. The use of devices that can traumatize the vaginal or uterine lining can cause bleeding. IUD is a common device to cause metrorrhagia.
Once the root cause of metrorrhagia is identified, the treatment shall focus on it. The main aim of any treatment plan is to provide comfort to the affected and to provide cure if possible. The following is the considered the holistic approach and interventions for metrorrhagia:
- Provide bed rest. There are severe cases where bleeding becomes uncontrolled or has progressed to hemorrhage. The doctor would observe the client and may need hospitalization to see progress and perform the necessary tests for diagnosis.
- Dilatation and curettage. This is somehow necessary when the case permits. When the cause has been incomplete abortion, the doctor shall perform this simple operation to remove components that can be of harm to the mother/woman.
- Oral contraceptives. This can help and assist in providing regular menstrual cycle thus maintaining the right hormonal levels of a woman.
- For hormonal problems, treatment shall include administration of estrogen-gestagen for 10 days. This shall help in correcting the estrogen level thus correcting the menstrual cycle of the client.
- Providing supplements. Provide iron supplements to client especially when they have suffered from severe blood loss.
It is highly advised that one shall have some lifestyle changes and restrictions after attaining diagnosis and treatment. One should follow the medical advice provided such as the major changes in day to day living. In cases of cancer patients, emotional help should be provided accordingly by the family members and health providers to help the sufferer to go through the great change in her life.